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1.
J Dairy Sci ; 105(8): 6563-6577, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35840407

RESUMO

This study was conducted to determine the effect of 1-stage homogenization (OSH) and 2-stage homogenization (TSH) and the addition of polysaccharides [κ-carrageenan (CR) or furcellaran (FR) at levels ranging from 0.000 to 1.000% (wt/wt)] on the physicochemical, viscoelastic, and mechanical vibration damping properties of processed cheese sauces (PCS) after 30 d of storage (6 ± 2°C). The basic chemical properties (pH, dry matter content) were similar for all tested samples. Viscoelastic measurements indicated that PCS rigidity was directly proportional to increasing CR or FR concentration and to the application of homogenization. The interactions between the application of homogenization and the concentration of polysaccharides used were also significant. Compared with OSH, TSH did not lead to any further increase in the rigidity. The preceding results were also supported by data obtained from a nondestructive method of mechanical vibration damping. No changes in water activity were observed in any PCS sample. Overall, the addition of FR or CR appeared to be highly suitable for increasing the emulsion stability of PCS. If PCS products with softer consistency are desired, then a concentration of CR/FR ≤0.250% (wt/wt) could be recommended together with OSH/TSH. For products for which a firmer PCS consistency is required, the addition of CR in concentrations of ≥0.500% (wt/wt) or FR in concentrations of ≥1.000% (wt/wt) together with OSH is recommended. Finally, as the concentration of polysaccharides increased, a darker PCS color was observed.


Assuntos
Queijo , Animais , Carragenina , Queijo/análise , Manipulação de Alimentos/métodos , Polissacarídeos , Reologia , Tireotropina
2.
Powder Technol ; 217(1): 510-515, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24850972

RESUMO

It is possible to assess viscoelastic properties of materials by means of the stress relaxation test. This method records the decrease in pressing power in a tablet at its constant height. The cited method was used to evaluate the time-dependent deformation for six various materials: microcrystalline cellulose, cellulose powder, hydroxypropyl methylcellulose, mannitol, lactose monohydrate, and hydrogen phosphate monohydrate. The decrease in pressing powering of a tablet during a 180 s period was described mathematically by the parameters of three exponential equations, where the whole course of the stress relaxation is divided into three individual processes (instant elastic deformation, retarded elastic deformation and permanent plastic deformation). Three values of the moduli of plasticity and elasticity were calculated for each compound. The values of elastic parameters ATi have a strong relationship with bulk density. The plastic parameters PTi represent particle tendency to form bonds. The values of plasticity in the third process PT3 ranged from 400 to 600 MPas. Mannitol had higher plasticity and lactose monohydrate on the contrary reduced plasticity. A linear relation exists between AT3 and PT3 for the third process. No similar interpretation of moduli calculated on the basis of three exponential equations has been realized yet.

3.
Dtsch Med Wochenschr ; 135(1-2): 19-21, 2010 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-20024878

RESUMO

HISTORY AND CLINICAL FINDINGS: A 77-year old women presented with dysphagia and loss of weight for two months INVESTIGATIONS, TREATMENT AND DIAGNOSIS: Endoscopy revealed a polypoid tumor was found in the upper third of the esophagus. It was resected endoscopically after a deeper infiltration of the esophageal wall and enlarged lymphadenopathy or distant metastasis had been ruled out. Histology showed a highly differentiated neuroendocrine tumor of the esophagus with beginning infiltration of the submucosa. It was completely resected. COURSE: The follow-up of 48 months showed no local recurrence or distant metastasis. This case report is the second description of a successful endoscopic treatment of a neuroendocrine tumor of the esophagus. CONCLUSION: EMR is a diagnostic and therapeutic tool in case of mucosal lesions of the gastrointestinal tract. Highly differentiated localized NET of the esophagus are very rare.


Assuntos
Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/cirurgia , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/cirurgia , Idoso , Transtornos de Deglutição/etiologia , Endoscopia Gastrointestinal , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/patologia , Feminino , Humanos , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/patologia , Resultado do Tratamento , Redução de Peso
4.
Eur J Gastroenterol Hepatol ; 13(7): 811-7, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11474311

RESUMO

OBJECTIVE: To compare prospectively the effectiveness of 1 year's treatment with pantoprazole versus ranitidine in order to prevent relapse after initial cure of reflux oesophagitis. For the first time the influence of the initial Helicobacter pylori status on therapeutic results was also taken into account. METHODS: In order to cure reflux oesophagitis, 396 patients with Savary/Miller stage II or III reflux oesophagitis were treated with pantoprazole 40 mg once daily for 8 weeks. Those who were H. pylori positive (n = 140) were also given 1 week of eradication treatment with clarithromycin 2 x 250 mg daily, metronidazole 2 x 400 mg daily, and a further 40 mg pantoprazole daily. The 303 patients who were endoscopically cured after the 8-week period were randomized and treated with either pantoprazole 20 mg (n = 199) or ranitidine 150 mg (n = 104) daily in double-blind fashion. The primary objective was to assess the time to endoscopically proven recurrence of reflux oesophagitis. RESULTS: In the intention-to-treat (ITT) population, 66.3% (118/178) of the pantoprazole group and 34.0% (32/94) of the ranitidine group showed neither endoscopic nor clinical symptoms of relapse after the 1-year treatment period (P < 0.0001) (per-protocol populations: 70.3% [109/155] in the pantoprazole group and 39.4% [28/71] in the ranitidine group). In the pantoprazole group, the relapse rate in initially H. pylori-positive patients who underwent eradication was 30.9% (17/55) and in H. pylori-negative patients 29% (29/100). CONCLUSIONS: Long-term treatment with 20 mg pantoprazole daily to prevent relapse of reflux oesophagitis in H. pylori-negative patients is significantly more effective than 150 mg ranitidine daily. The initial H. pylori eradication treatment does not influence the outcome of the long-term treatment.


Assuntos
Antiulcerosos/uso terapêutico , Benzimidazóis/uso terapêutico , Esofagite Péptica/tratamento farmacológico , Esofagite Péptica/microbiologia , Infecções por Helicobacter/complicações , Helicobacter pylori , Ranitidina/uso terapêutico , Sulfóxidos/uso terapêutico , 2-Piridinilmetilsulfinilbenzimidazóis , Adulto , Antibacterianos/uso terapêutico , Método Duplo-Cego , Inibidores Enzimáticos/uso terapêutico , Esofagite Péptica/prevenção & controle , Feminino , Infecções por Helicobacter/tratamento farmacológico , Antagonistas dos Receptores H2 da Histamina/uso terapêutico , Humanos , Masculino , Omeprazol/análogos & derivados , Pantoprazol , Inibidores da Bomba de Prótons , Prevenção Secundária
5.
Dtsch Med Wochenschr ; 125(15): 455-8, 2000 Apr 14.
Artigo em Alemão | MEDLINE | ID: mdl-10800443

RESUMO

HISTORY AND ADMISSION FINDINGS: A 55-year-old woman had for 5 years been suffering from severe burning thoracic pain. She had typical risk factors for cardiovascular disease, namely hypertension, chronic smoking, obesity and hypercholesterolaemia. She had been hospitalized several times for suspected myocardial infarction, but coronary heart disease had been excluded by cardiac examination, including angiocardiography. The only contributory admission finding was epigastric pain on pressure. INVESTIGATION: Gastroscopy revealed a non-erosive duodenitis and chronic antral gastritis. The cardia was tightly closed and there were no signs of reflux oesophagitis. Manometry in the oesophagus showed frequent simultaneous contractions and marked increase in pressure amplitude, predominantly in the distal segment, indicating diffuse oesophageal spasms. TREATMENT AND COURSE: Drug treatment with calcium channel blockers gave only brief relief from the thoracic pain. But longitudinal oesophageal myotomy via thoracoscopy brought about complete pain relief, which has now persisted for 3 years. CONCLUSION: Thoracoscopic longitudinal oesophageal myotomy can provide a therapeutic alternative in patients with oesophageal spasms when drug therapy and pneumatic oesophageal dilatation have failed.


Assuntos
Espasmo Esofágico Difuso/cirurgia , Esôfago/cirurgia , Toracoscopia , Dor no Peito/etiologia , Doença das Coronárias/diagnóstico , Diagnóstico Diferencial , Espasmo Esofágico Difuso/diagnóstico , Feminino , Humanos , Manometria , Pessoa de Meia-Idade , Fatores de Risco
6.
Helicobacter ; 4(4): 266-71, 1999 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-10597397

RESUMO

BACKGROUND: Short-term, low-dose triple regimens composed of proton-pump inhibitors (PPI) and two antibiotics are the current gold standard therapy for cure of Helicobacter pylori infection. To date, the effect of PPI pretreatment on eradication outcome is not known. The aim of this study was to evaluate the influence of pretreatment with pantoprazole on the efficacy of an ensuing triple therapy. METHODS: In this open, randomized, monocenter, parallel group comparison, 107 patients with duodenal ulcer or functional dyspepsia were assigned to receive one of the following treatment regimens: a 7-day triple therapy with pantoprazole, 40 mg bid; clarithromycin, 250 mg bid; and metronidazole, 400 mg bid, which was either preceded or followed by a 7-day therapy with pantoprazole, 40 mg (P-PCM or PCM-P). Assessment of H. pylori status was performed by a biopsy urease test and 13C urea breath test at the initial visit and 13C urea breath test at all follow-up visits. RESULTS: The 7-day pantoprazole pretreatment resulted in a significant decline of the delta values of the 13C urea breath test. H. pylori infection was cured in 47 of 52 intention-to-treat patients of the P-PCM group (90%; 95% confidence interval, 79-97%) and in 46 of 53 of the PCM-P group (87%; 95% confidence interval, 75-95%). CONCLUSIONS: Pretreatment with pantoprazole suppresses H. pylori but does not impair the efficacy of a consecutive short-term, low-dose triple therapy.


Assuntos
Antiulcerosos/uso terapêutico , Benzimidazóis/uso terapêutico , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Sulfóxidos/uso terapêutico , 2-Piridinilmetilsulfinilbenzimidazóis , Antiulcerosos/farmacologia , Benzimidazóis/farmacologia , Testes Respiratórios , Quimioterapia Combinada , Úlcera Duodenal/tratamento farmacológico , Úlcera Duodenal/patologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Humanos , Omeprazol/análogos & derivados , Pantoprazol , Sulfóxidos/farmacologia , Ureia/análise , Urease/metabolismo
7.
Scand J Gastroenterol ; 34(11): 1153-6, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10582768

RESUMO

BACKGROUND: The 13C mixed-triglyceride breath test (MTB) has been proposed for the non-invasive assessment of duodenal pancreatic lipase activity. Until now, stable isotope analysis of CO2 of the MTB has been carried out with isotope ratio mass spectrometry (IRMS). The aim of the present study was to compare MTB results by using the new non-dispersive infrared spectrometry (NDIRS) and the IRMS. METHODS: Ten healthy volunteers and 10 patients with chronic pancreatitis and exocrine insufficiency were studied. After an overnight fast each subject received a test meal containing 250 mg 1,3 distearyl, 2[13C] octanoyl glycerol. Breath samples were taken at base line and at 30-min intervals over a period of 6 h postprandially. The 13C/12C ratio was determined in each breath sample by NDIRS and CF-IRMS as delta values. Results were expressed as delta over base line (DOB (per 1000)) and as cumulative percentage dose of 13C recovered (cPDR (%)). Correlations between IRMS and NDIRS were tested by linear regression analysis. For measuring agreement an Altman-Bland plot was performed. RESULTS: A linear correlation was found (DOB: y = 0.645 +/- 0.040 x + 1.496 +/- 0.089, r = 0.70, P < 0.0001; cPDR: y = 1.269 +/- 0.031 x + 2.010 +/- 0.353, r = 0.93, P < 0.0001). For DOB the mean difference (d) was 1.0/1000, and the standard deviation (s) of the difference was 1.3/1000. The limits of agreement (d +/- 2 s) were -1.6/1000 and 3.6/1000. CONCLUSION: The comparison of DOB and cPDR values by NDIRS and IRMS shows a moderate to good linear correlation. However, the distance of the limits of agreement is rather wide. Consequently, the validity of the MTB is diminished, which makes MTB by NDIRS less suitable for exact evaluation of non-invasive assessment of duodenal pancreatic lipase activity. Further studies are necessary to determine sensitivity and specificity of the MTB with NDIRS in larger study populations.


Assuntos
Testes Respiratórios/métodos , Dióxido de Carbono/análise , Pancreatite/diagnóstico , Triglicerídeos/farmacocinética , Adulto , Idoso , Isótopos de Carbono , Doença Crônica , Feminino , Humanos , Modelos Lineares , Lipase/metabolismo , Masculino , Pessoa de Meia-Idade , Pâncreas/enzimologia , Pancreatite/enzimologia , Espectrofotometria Infravermelho/métodos
8.
Hepatogastroenterology ; 46(27): 1759-64, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10430339

RESUMO

BACKGROUND/AIMS: The aim of the study was to evaluate esophageal motility patterns in patients with chest pain with and without coronary artery disease, in order to elucidate the question: Does "non-cardiac" chest pain really exist? METHODOLOGY: Patients with chest pain and normal coronary angiograms, patients with chest pain and coronarographically diagnosed coronary artery disease and controls were prospectively studied with long-term manometry. RESULTS: The pressure amplitudes were 38.3 (NCA)/39.82(CAD) and 30 (CG) mmHg (p<0.02, p<0.02) distally and 30/28.1 and 25.5 mmHg (p<0.02) proximally. The percentage of propulsive contractions were 51.5%/45% and 53.5% (p<0.05) and of simultaneous contractions were 18.5%/23% and 10% (p<0.0005, p<0.0001). CONCLUSIONS: Esophageal motility patterns of patients with chest pain and normal coronary angiograms and coronary artery disease differ significantly from controls. Both patient groups show a considerable overlap in motility disturbances. These data indicate that the term "non-cardiac" chest pain in fact does not sufficiently characterize patients' status.


Assuntos
Dor no Peito/fisiopatologia , Doença das Coronárias/fisiopatologia , Transtornos da Motilidade Esofágica/fisiopatologia , Angina Pectoris/diagnóstico , Angina Pectoris/fisiopatologia , Dor no Peito/etiologia , Angiografia Coronária , Doença das Coronárias/diagnóstico , Diagnóstico Diferencial , Transtornos da Motilidade Esofágica/diagnóstico , Esôfago/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peristaltismo/fisiologia
10.
Dtsch Med Wochenschr ; 124(21): 650-2, 1999 May 28.
Artigo em Alemão | MEDLINE | ID: mdl-10382544

RESUMO

HISTORY AND ADMISSION FINDINGS: One year after an Echinococcus granulosa cyst had been resected in a 37-year-old woman she presented for follow-up. She was without symptoms and physical examination was unremarkable. INVESTIGATIONS: Sonography and computed tomography showed renewed growth of the cyst (6.5 cm diameter) in the VIth liver segment. The Echinococcus antibody titre was increased to 1:20 (normal 1:5). DIAGNOSIS, TREATMENT AND COURSE: An echinococcal cyst was again diagnosed and a pericystectomy with intrahepatic drainage performed. A bile leak developed postoperatively through an open bile duct at the operative site. This duct was selectively visualized by endoscopic retrograde choleangiography and its distal part embolized with 1.5 ml Histoacryl: there was no further bile leak. No relevant clinical side effects occurred. CONCLUSION: Selective embolization is a possible alternative to currently employed procedures for stopping bile leaks.


Assuntos
Ductos Biliares/patologia , Bile/metabolismo , Equinococose Hepática/cirurgia , Embolização Terapêutica , Complicações Pós-Operatórias , Adulto , Animais , Anticorpos Anti-Helmínticos/sangue , Colangiopancreatografia Retrógrada Endoscópica , Equinococose Hepática/diagnóstico por imagem , Echinococcus/imunologia , Feminino , Granuloma/cirurgia , Humanos , Recidiva , Tomografia Computadorizada por Raios X , Ultrassonografia
11.
Dtsch Med Wochenschr ; 124(5): 103-8, 1999 Feb 05.
Artigo em Alemão | MEDLINE | ID: mdl-10076549

RESUMO

BACKGROUND AND OBJECTIVE: The 13C-mixed-triglyceride CO2-exhalation test (MTE) has been proposed for the noninvasive assessment of intraluminal duodenal pancreatic lipase activity. Up to now, stable isotope analysis of carbon dioxide of the MTE has been carried out with isotope ratio mass-spectrometry. The aim of the present study was to evaluate the MTE in patients with morphological signs of chronic pancreatitis (stages I-III) and exocrine pancreatic insufficiency by using an isotope-selective nondispersive infrared spectrometer (NDIRS). PATIENTS AND METHODS: 20 healthy volunteers (9 females, 11 males, age range 19-61 years) and 16 patients (7 females, 9 males, age range 33-76 years) were examined. After an overnight fast each patient received a solid-liquid test meal containing 250 mg 1,3 distearyl, 2[13C] octanoyl glycerol. Breath samples were obtained at baseline and at 30 min intervals over a period of 6 h after the test meal. The 13C/12C isotope ratio in each breath sample was determined by NDIRS as delta (%) and delta over baseline (%). Results were expressed as cumulative percentage dose of 13C recovered (cPDR) at 3, 4, 5, 6 h and maximal PDR (PDRpeak) (median; 5./95. percentile). RESULTS: Significant lower values concerning cPDR 3, 4, 5, 6 hours and PDRpeak [%] were found between healthy subjects and patients with chronic pancreatitis (p < 0.05): cPDR 6 h: 8.1 (0.4-20.5)% vs 29.1 (10.3-59.3)%; PDRpeak: 4.7 (0.4-10.2)% vs 9.2 (5.4-14.3)%. INTERPRETATION: In general, the MTE discriminates between healthy controls and patients with chronic pancreatitis and exocrine pancreatic insufficiency. However, the MTE using NDIRS cannot be recommended as a method of clinical routine because of marked data overlap between pathologic and normal values.


Assuntos
Testes Respiratórios/métodos , Dióxido de Carbono/análise , Lipase/metabolismo , Pâncreas/fisiopatologia , Pancreatite/diagnóstico , Triglicerídeos/farmacocinética , Adulto , Idoso , Isótopos de Carbono , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/enzimologia , Pâncreas/fisiologia , Pancreatite/enzimologia , Pancreatite/fisiopatologia , Valores de Referência , Espectrofotometria Infravermelho/métodos , Especificidade por Substrato , Fatores de Tempo
12.
Dtsch Med Wochenschr ; 124(5): 114-8, 1999 Feb 05.
Artigo em Alemão | MEDLINE | ID: mdl-10076551

RESUMO

HISTORY AND ADMISSION FINDINGS: A 57-year-old man had for the past 18 months complained of recurrent, recently worsening, belt-like backache radiating ventrally. On admission a skin rash consisting of blister and pustules was noted on the palms of both hands. He had pain on pressure over the right upper abdomen, an enlarged prostate and definite pain on percussing the vertebral column with restricted movement of the thoracic vertebral column, but no other physical signs. INVESTIGATIONS: Radiology revealed clearly increased sclerosis of several thoracic vertebrae with osteolytic destruction and a paravertebral soft tissue tumor. Search for a primary tumor was unsuccessful. Bone scintigraphy demonstrated nuclide enrichment of the thoracic vertebrae and of the sternoclavicular joints without increase in the LeukoScan. These findings indicated the diagnosis of SAPHO syndrome (synovitis-acne-pustulosis-hyperostosis-osteomyelitis). TREATMENT AND COURSE: Rapid subjective and objective improvement followed the administration of clindamycin and ibuprofen. CONCLUSION: In case of bone pain of uncertain aetiology, especially when associated with skin rash, the rare SAPHO syndrome should be considered in the differential diagnosis, avoiding lengthy diagnostic steps and allowing early treatment.


Assuntos
Síndrome de Hiperostose Adquirida/fisiopatologia , Dor Intratável , Coluna Vertebral/patologia , Síndrome de Hiperostose Adquirida/diagnóstico por imagem , Síndrome de Hiperostose Adquirida/patologia , Osso e Ossos/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Osteólise/diagnóstico por imagem , Cintilografia , Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X
13.
Z Gastroenterol ; 37(12): 1139-43, 1999 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-10666836

RESUMO

The 13C-methacetin breath test (MBT) has been proposed for the noninvasive evaluation of the hepatic mixed function oxidase activity. Up to now, stable isotope analysis of carbon dioxide of the MBT has been carried out with isotope ratio mass spectrometry (IRMS). The aim of the present study was to test a recently developed isotope-selective nondispersive infrared spectrometer (NDIRS) in comparison to IRMS in healthy volunteers and patients with liver cirrhosis. Ten healthy volunteers (range 22 to 76 years) and ten patients with histologically proven liver cirrhosis (range 47 to 71 years; Child Pugh score A = 5, B = 3, C = 2) were studied. After an overnight fast each subject received 2 mg/kg BW of 13C-methacetin dissolved in 100 ml of tea. Breath samples were obtained before substrate administration and after 5, 10, 15, 20, 30, 40, 50, 60, 80, 100, 120, 150, 180 min. The 13C/12C-ratio was analyzed in each breath sample both by NDIRS (IRIS, Wagner Analysen Technik, Worpswede, Germany) and CF-IRMS (ABCA, Europa Scientific, Crewe, UK). Results were expressed as delta over baseline (DOB [/1000]) and as cumulative percentage doses of 13C recovered (cPDR [%]) at each time interval. Correlations between IRMS and NDIRS were tested by linear regression correlation. For measuring agreement an Altman-Bland-plot was performed. Applying correlation analysis a linear correlation was found (DOB: y = 1.068 +/- 0.0012.x + 2.088 +/- 0.2126, r = 0.98, p < 0.0001; cPDR: y = 1.148 +/- 0.0109.x + 0.569 +/- 0.172; r = 0.99, p < 0.0001). For DOB the mean difference (d) was 2.9/1000 and the standard deviation (SD) of the difference was 2.7/1000. The limits of agreement (d +/- SD) were -2.5/1000 and 8.3/1000. The comparison of DOB- and cPDR-values by NDIRS and IRMS shows a high linear correlation. However, the distance of the limits of agreement is wide. Consequently, the validity of the MBT could be influenced which could make MBT by NDIRS unprecise for exact evaluation of hepatocellular dysfunction. Further studies are necessary to determine sensitivity and specifity of the MBT with NDIRS in larger study populations.


Assuntos
Acetamidas , Isótopos de Carbono , Cirrose Hepática/diagnóstico , Testes de Função Hepática , Espectrometria de Massas , Espectrofotometria Infravermelho , Adulto , Idoso , Feminino , Humanos , Fígado/enzimologia , Masculino , Pessoa de Meia-Idade , Oxigenases de Função Mista/metabolismo , Valores de Referência , Sensibilidade e Especificidade
14.
Dtsch Med Wochenschr ; 123(49): 1467-71, 1998 Dec 04.
Artigo em Alemão | MEDLINE | ID: mdl-9861887

RESUMO

BACKGROUND AND OBJECTIVE: Cytochrome-P450-dependent liver function can be measured with the 13C-methacetin breath test (MBT). This has heretofore been done with the use of a mass-spectrometer. This study was undertaken to evaluate the MBT (NDIRS) done with the isotope-selective nondispersive infrared spectrometer. PATIENTS AND METHODS: 20 healthy volunteers (ten women, ten men, aged 22-76 years) and 16 patients (ten women, six men, aged 48-71 years) with histologically confirmed liver cirrhosis (Child-Pugh stage A [n = 7], B [n = 5] or C [n = 4]) were given 13C-methacetin in 100 ml of tea after a 12-hour fasting period. Breath tests were performed before the test drink and 5, 10, 15, 20, 30, 40, 50, 60, 80, 100, 120, 150 and 180 min thereafter. The ratio of 13C to 12C was determined, as delta (/1000), and from it the maximal percentage rate (PDRmax) calculated, as well as the cumulative rate (cPDRmax) after 30, 60, 120 and 180 min (Median and 5th and 95th percentiles). RESULTS: For patients with liver cirrhosis there were significantly lower values for cPDRmax and cPDR after 30, 60, 120 and 180 min than in the healthy subjects (P < 0.002): PDR [%]/h: 3.9 (0.7-15.9) vs. 36.5 (23.1-50.0); cDPR 30 min [%]: 1.1 (-0.2-6.0) vs. 12.4 (7.6-17.1); cDPR 3 h [%]: 9.8 (-2.3-27.5) vs. 36.0 (29.9-45.1). There were significant differences among the patients, depending on their Child-Pugh staging. CONCLUSION: The MBT with the cost-effective NDIRS can reliably and noninvasively distinguish between healthy subjects and patients with liver cirrhosis. The test is therefore suitable for the quantitative analysis of liver functions.


Assuntos
Acetamidas , Testes Respiratórios/métodos , Cirrose Hepática/diagnóstico , Testes de Função Hepática/métodos , Idoso , Análise de Variância , Isótopos de Carbono , Estudos de Avaliação como Assunto , Feminino , Humanos , Cirrose Hepática Alcoólica/diagnóstico , Testes de Função Hepática/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Espectrofotometria Infravermelho/instrumentação , Espectrofotometria Infravermelho/métodos , Espectrofotometria Infravermelho/estatística & dados numéricos , Estatísticas não Paramétricas , Fatores de Tempo
15.
Hepatogastroenterology ; 45(22): 1165-71, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9756027

RESUMO

BACKGROUND/AIMS: Chronic alcoholism is known to effect gastric motor activity. An association between gastric motility disorders and abnormal myoelectrical activity has been observed in various gastrointestinal and extra-intestinal diseases. The aim of this study was to investigate the effect of chronic alcoholism on gastric emptying and antral myoelectrical activity. METHODOLOGY: Electrogastrography (EGG) was performed on 20 chronic alcoholics with chronic dyspepsia using a pair of electrodes sonographically placed on the skin overlying the gastric antrum. After an overnight fast, patients were tested over a period of one hour in the a) fasting and b) fed state, after ingestion of a 370 kcal liquid-solid test meal. The following EGG parameters were determined: dominant frequency (DF (cpm); DF (%) in the normal range (2-4 cpm); bradygastria (<2 cpm); tachygastria (4-10 cpm); dominant frequency instability coefficient (DFIC), and postprandial to fasting power ratio (PR). The data were correlated with results obtained from 20 controls matched for age and sex. In 18 alcoholics, the EGG data were compared to the percentage of radionuclides (liquid phase labeled with 99m Tc colloid) remaining in the stomach after 60 minutes (%) (gamma camera system). Moreover, for the alcoholics, various parameters such as ethanol consumption, and gastrointestinal symptoms were determined and related to EGG values and scintigraphy. RESULTS: About 50% of the alcoholics showed delayed gastric emptying compared to normal values previously reported (t 60 values: >68%). In opposite to scintigraphy, the alcoholics did not exhibit abnormalities in antral myoelectrical activity. They had significantly decreased bradygastria measures compared to controls (p<0.05). The scintigraphic t 60 values did not correlate either with EGG values or with dyspepsia and clinical parameters. EGG values did not correlate with dyspepsia. However, increased preprandial DF was significantly correlated with ethanol consumption. CONCLUSIONS: Chronic alcoholism induces a disturbance of gastric emptying, probably resulting from toxic damage of the gastrointestinal smooth muscles. Disturbances in antral myoelectrical activity were not found.


Assuntos
Alcoolismo/fisiopatologia , Dispepsia/fisiopatologia , Esvaziamento Gástrico , Estômago/fisiologia , Adulto , Alcoolismo/complicações , Dispepsia/complicações , Dispepsia/diagnóstico por imagem , Eletrofisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia
16.
Am J Gastroenterol ; 93(10): 1919-24, 1998 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9772056

RESUMO

OBJECTIVE: Eradication of Helicobacter pylori (H. pylori) is recommended as the first-line therapeutic concept for reliable long-term prevention of duodenal ulcer (DU) relapse. Current treatment regimens vary in efficacy, complexity, and compliance. To assess the efficacy of pantoprazole in H. pylori eradication in parallel groups of patients using two eradication regimens. METHODS: Patients, (18-85 yr old; intention-to-treat, n=286) with proven DU, positive rapid urease test (biopsy), and 13C-urea breath test (UBT) were included in a prospective, randomized, multicenter study. Modified triple therapy consisted of 40 mg pantoprazole b.i.d., 500 mg clarithromycin t.i.d., and 500 mg metronidazole t.i.d. for 7 days (PCM therapy); dual therapy consisted of 40 mg pantoprazole b.i.d. and 500 mg clarithromycin t.id. for 14 days (PC therapy). In both groups 40 mg pantoprazole o.d. was given until day 28 when healing of DU was evaluated endoscopically; H. pylori status was assessed by UBT on day 56. RESULTS: H. pylori eradication rate was 95% in PCM versus 60% in PC therapy groups (perprotocol population, p < 0.001), and 82% in PCM versus 50% in PC therapy in the intention-to-treat patient population (p < 0.001). The DU healing rate was 98% in the PCM and 95% in the PC therapy groups (per-protocol population). Both regimens were similarly well tolerated. Adverse events in both regimens included taste disturbance, diarrhea, and increased serum concentration of liver enzymes, at an incidence of < 10%. CONCLUSIONS: Compared to 2-wk PC therapy (pantoprazole and clarithromycin), the 1-wk PCM therapy (pantoprazole, clarithromycin, and metronidazole) is a significantly superior and highly promising strategy for eradication of H. pylori.


Assuntos
Antiulcerosos/uso terapêutico , Benzimidazóis/uso terapêutico , Úlcera Duodenal/microbiologia , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Inibidores da Bomba de Prótons , Sulfóxidos/uso terapêutico , 2-Piridinilmetilsulfinilbenzimidazóis , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Antiulcerosos/efeitos adversos , Benzimidazóis/efeitos adversos , Claritromicina/efeitos adversos , Claritromicina/uso terapêutico , Esquema de Medicação , Quimioterapia Combinada , Úlcera Duodenal/tratamento farmacológico , Feminino , Humanos , Masculino , Metronidazol/efeitos adversos , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Omeprazol/análogos & derivados , Pantoprazol , Estudos Prospectivos , Sulfóxidos/efeitos adversos , Fatores de Tempo
18.
Helicobacter ; 3(3): 206-11, 1998 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9731993

RESUMO

BACKGROUND: Acid pump inhibitors combined with antimicrobials cure gastritis and peptic ulcer disease but a standard therapy has not yet been established. We therefore investigated a triple therapy with pantoprazole. METHODS: The aim of this open-label monocenter trial, involving 30 intention-to-treat patients with peptic ulcer disease or functional dyspepsia, was to assess the H. pylori cure rate after a 7-day triple therapy with pantoprazole (40 mg bid) plus metronidazole (500 mg bid) and amoxicillin (1 g bid). The H. pylori status was assessed by rapid urease test, histological examination and culture at the initial examination and by histological examination and culture at the study end 4 weeks after ending all therapy. RESULTS: At the end of the trial H. pylori was eradicated in 21 of 27 per protocol patients (78%; 95% CI 58-91%) and in 21 of 30 patients included in the trial (70%; 95% CI 51-85%). In 15 of 16 per protocol patients with metronidazole-sensitive strain (94%; 95% CI 70-100%) the infection was cured, but in contrast eradication was accomplished in only one of 3 patients with a metronidazole-resistant H. pylori strain. Post-treatment resistance to metronidazole was observed in 6 cases, although 4 of them had had H. pylori strains sensitive to metronidazole at the initial visit. The gastritis had clearly been improved, and the activity of gastritis had completely disappeared 4 weeks after treatment. Seven adverse events were observed in 7 patients, the intensity of which was moderate in 6 cases. CONCLUSIONS: This short-term triple therapy with pantoprazole, amoxicillin and metronidazole provides an effective regimen especially in patients with metronidazole-sensitive strain.


Assuntos
Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Antiulcerosos/uso terapêutico , Benzimidazóis/uso terapêutico , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Metronidazol/uso terapêutico , Sulfóxidos/uso terapêutico , 2-Piridinilmetilsulfinilbenzimidazóis , Adolescente , Adulto , Idoso , Amoxicilina/administração & dosagem , Amoxicilina/efeitos adversos , Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Antiulcerosos/administração & dosagem , Antiulcerosos/efeitos adversos , Benzimidazóis/administração & dosagem , Benzimidazóis/efeitos adversos , Quimioterapia Combinada , Dispepsia/tratamento farmacológico , Dispepsia/microbiologia , Humanos , Metronidazol/administração & dosagem , Metronidazol/efeitos adversos , Pessoa de Meia-Idade , Omeprazol/análogos & derivados , Pantoprazol , Cooperação do Paciente , Penicilinas/administração & dosagem , Penicilinas/efeitos adversos , Penicilinas/uso terapêutico , Úlcera Péptica/tratamento farmacológico , Úlcera Péptica/microbiologia , Sulfóxidos/administração & dosagem , Sulfóxidos/efeitos adversos , Resultado do Tratamento
19.
Dtsch Med Wochenschr ; 123(28-29): 855-60, 1998 Jul 10.
Artigo em Alemão | MEDLINE | ID: mdl-9693655

RESUMO

BACKGROUND AND OBJECTIVE: Abnormalities of gastric myoelectric activity can be measured by electrogastrography (EGG). Such dysfunctions can be associated with disorders of gastric motility. It was the aim of this study to investigate the relationship between gastric electrical activity and motility in patients with dyspepsia due to gastrointestinal or extraintestinal disease. PATIENTS AND METHODS: 135 consecutive patients with dyspepsia (standardized score) were enrolled in this prospective study including patients with functional dyspepsia (FD) (n = 25), dyspepsia in diabetes mellitus type II (n = 27), hyperthyroidism (n = 23), progressive systemic scleroderma (PSS) (n = 20), chronic alcoholism (n = 20), and 20 patients with gastric lesions: gastric ulcer (n = 10) or gastric cancer (n = 10). The EGG measurements were performed over 60 min pre- and post-prandially state after ingestion of a solid-liquid test meal (370 kcal). The following parameters were measured: dominant electrical frequency (DF), percentage of DF in the normal frequency range (2-4 cpm), bradygastria (< 2 cpm), tachygastria (4-10 cpm), dominant frequency instability coefficient (DFIC), and power ratio. The data were compared with results in 40 healthy persons. The gastric emptying was determined by the gastric retention of 99mTc colloid after 60 min (gamma camera). RESULTS: Nearly 50% of FD patients had delayed gastric emptying (gastric retention after 60 min > 68%): they patients exhibited significantly more tachygastrias than those with normal gastric emptying (P < 0.05). Patients with diabetes mellitus type II, PSS and chronic alcoholism showed normal electrical activity, although gastric emptying was delayed in nearly 50%. The hyperthyroid patients had increased tachygastria without abnormal gastric motility. Gastric lesions did not produce pathological electrogastrograms. The dyspepsia score did not correlate with either EGG or radioscintigraphy in the various patient groups. CONCLUSIONS: Electrogastrography can detect tachygastrias, which are significantly increased in some patients with functional dyspepsia. Because of therapeutic consequences electrogastrography seems to be indicated in patients with functional dyspepsia.


Assuntos
Dispepsia/fisiopatologia , Esvaziamento Gástrico , Estômago/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Alcoolismo/complicações , Alcoolismo/fisiopatologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/fisiopatologia , Dispepsia/etiologia , Eletromiografia , Jejum/fisiologia , Feminino , Humanos , Hipertireoidismo/complicações , Hipertireoidismo/fisiopatologia , Masculino , Pessoa de Meia-Idade , Período Pós-Prandial/fisiologia , Estudos Prospectivos , Valores de Referência , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/fisiopatologia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/fisiopatologia , Úlcera Gástrica/complicações , Úlcera Gástrica/fisiopatologia
20.
Dtsch Med Wochenschr ; 123(12): 341-6, 1998 Mar 20.
Artigo em Alemão | MEDLINE | ID: mdl-9551037

RESUMO

BACKGROUND AND OBJECTIVE: It has been noted in previous manometric examinations of the oesophagus in patients with chest pain that abnormal motility was often associated with arterial hypertension. A systematic study of this relationship was therefore undertaken. PATIENTS AND METHODS: In 40 patients with chest pain (18 women and 22 men, mean age 54.7 [24-70] years) and in 20 healthy volunteers (12 men, 8 women, mean age 50.8 [22-63] years) standardized oesophageal manometry and arterial blood pressure monitoring were performed over 24 hours. Coronary heart disease and gastrointestinal lesions had been excluded by angiography and endoscopy, respectively. RESULTS: 20 patients (group H) had hypertension (median 24-hour blood pressure > 135/85 mmHg), while 20 patients (group N) and the normal controls (group K) were normotensive. Oesophageal manometry data differed significantly between the three groups regarding distal pressure amplitude (in hPa [hectopascals]; group H: 62 hPa*,**, group N 44 hPa* and group K 36 hPa**; [*P < 0.0005]) and the proportion of simultaneous contractions (group H 23%, group N 22%**, group K 10%***; ***P < 0.001). The hypertensive patients had significantly more frequent motility abnormalities than normal controls (13/20 vs 4/20, P < 0.001); while normotensive patients had more frequent episodes of abnormal propulsion in the oesophagus (proportion of propulsive contractions in group H: 53%, in N: 44%, in K: 59%; P < 0.01). CONCLUSION: Oesophageal motility differed significantly in patients with chest pain from that in healthy controls. Patients with chest pain and hypertension more frequently had oesophageal hypermotility. This suggests a generalized abnormality of smooth muscle.


Assuntos
Dor no Peito/etiologia , Transtornos da Motilidade Esofágica/complicações , Esôfago/fisiopatologia , Hipertensão/complicações , Adulto , Idoso , Monitorização Ambulatorial da Pressão Arterial , Transtornos da Motilidade Esofágica/epidemiologia , Transtornos da Motilidade Esofágica/fisiopatologia , Feminino , Humanos , Hipertensão/fisiopatologia , Incidência , Masculino , Manometria , Pessoa de Meia-Idade , Fluxo Pulsátil
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